Objective To study the value of video assisted thoracoseopy(VATS)in the diagnosis and treatment of patient with indeterminate solitary pulmonary nodules. Methods A total of 35 patients with the solitary pulmonary nodules (＜3 cm in diameter) were enrolled in this study.Video assisted thoracoseopy was employed to resect the nodules for rapid frozen sections diagnosis. The patients with a malignant diagnosis were treated further. For those benign cases, surgical treatments were stopped. Results Among the total of cases, 12 were diagnosed with malignant tumor including 11 cases of primary lung cancer, who received radical resection plus mediastinal lymph nodes dissection by video assisted thoracoscopy using small auxiliary incision. 1 case of metastatic lung cancer patients received palliative edged resection of the nodules. The other 23 patients were diagnosed as having benign lesions (pulmonary inflammatory pseudotumor in 8, hamartoma in 4, fibrotic nodules in 3, pulmonary sclerosing hemangioma in 4, pulmonary tuberculoma in 3, and pulmonary cyst in 1). Conclusion Video assisted thoraeoscopy is valuable in diagnosing indeterminate solitary pulmonary nodules. By using the method, the diagnostic rate of malignant tumor can be increased without a long-term observation. It is helpful in the early diagnosis and treatment of pulmonary carcinoma.%目的 探讨电视胸腔镜在性质不明的肺孤立性结节中的诊治价值.方法 对35例不明原因肺孤立性小结节(直径＜3 cm)应用胸腔镜技术行肺小结节病灶切除,术中快速冰冻切片,对恶性病变迸一步手术,良性病变则结束手术.结果 诊断恶性病变12例,其中11例原发性肺癌行胸腔镜辅助小切口肺癌根治术,1例肺转移癌行病灶切除.23例良性病变(肺炎性假瘤8例,肺错构瘤4例,机化性纤维化结节3例,肺硬化性血管瘤4例,结核瘤3例,肺囊肿1例)仅行病灶切除.35例随访6～30个月,平均24个月,23例良性病变无复发;12例原发肺癌中,10例健康存活,2例分别术后18、30个月死亡.结论 胸腔镜手术在诊断不明原因肺孤立性小结节中具有较高的应用价值,可明显提高恶性肿瘤的诊断率,避免长期观察和等待,有助于早期肺癌的诊治.
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